Kesso Gabrielle van Zutphen, Sight and Life’s Knowledge and Research Specialist, provides the key points from her experience at the Experimental Biology 2017 conference in Chicago.
The Experimental Biology 2017 conference in Chicago, Illinois presented another thought-provoking experience. Each session provided fantastic speakers and opportunities for networking and sharing nutrition research with colleagues from around the world!
The below offers some key insights we can gain from the conference.
Convened by the American Society for Nutrition, the workshop “Food Systems, Nutrition and Health in a Changing Environment” marked a defiant start into Experimental Biology 2017.
The terms “multi-sectoral” and “multi-disciplinarily” have both become familiar to the nutrition world in the past few decades; perhaps even a little too much? Working across sectors is widely known as being a fundamental necessity to improve nutrition, and yet this fascinating workshop on “Building Connections to Address Global Priorities” chaired by Dr. John Finley, USDA-ARS in Human Nutrition Research, and Dr. Daniel J Raiten, Health Scientist Administrator at NICHD/NIH, gave a renewed and fresh insight into this often-overwhelming topic. The session provided clear vision on a topic that has repeatedly proven to be a difficult subject to address due to its complexity and hybrid nature.
The workshop was built around the intersection of food systems, human nutrition, and health in the global response to changes in population, demographics, environmental, and climate change. Creating a common language, having data sets that speak to each other, bringing all stakeholders to the table (notably from the food industry), and gaining the interest of young researchers were all highlighted as areas of importance to developing solid plans that will bring this agenda forward – the challenge is real and urgent!
Raiten provided an overview of the many interactions between climate and environmental change, food, nutrition and health, emphasizing the need for further collaboration as each sector has implications on the others. Key to Raiten’s talk was the emphasis on clarifying the often misused and distorted terminology around food, nutrition, and diets. Indeed, nutrition (not just food) is a biological variable that must be integrated as an input and output of the impact of climate/environmental change on health.
Food: accessible and available source of essential nutrients.
Diet: food and other sources of nutrients consumed; diet quality and nutritional security.
Nutrition: biological outcome resulting from a series of biological process beginning with consumption of food optimally in a well-balanced diet.
Dr. Dan Raiten (NIH)
What is being done now that can provide lessons in moving forward? “Avoiding the unintended consequences of interventions” presented by Dr. Lindsay Allen, Director of the USDA ARS Western Human Nutrition and UC Davis Research Professor for the Department of Nutrition, provided intuitive principles from interventions and strategies that have been intended to positively impact health functions by improving micronutrient status. As the title suggests, adverse consequences such as the failure to measure food and nutrient intake before making decisions, followed by inadequate assessment of pre- and/or post-nutritional status of intended recipients, need to be mitigated. In addition, the lack of knowledge about the requirements and biological effects of interventions and optimal dose of foods require reviewing.
“The priority for the future is a nutrition-driven food system that sits within environmental limits.”– Dr. Alison Van Eenennaam, Cooperative Extension Specialist in the field of Animal Genomics and Biotechnology in the Department of Animal Science at University of California, Davis
For this to happen, we need to strive for sustainable trade-offs. Considering these will help us agree on an acceptable system – not an easy task according to Van Eenennaam when there are competing worldviews!
So, what is your worldview? Problems tend to be defined from the nature of our perspective and expertise as opposed to making sure the nature of the challenge is fully understood. Different world views rarely sit at the same table – in fact, too often, they have trouble understanding each other and working together. This is counterproductive as each view has its own merit and will often offer valuable insights when identifying and addressing the issue at hand.
Moving forward, understanding the context we work in by making trade-offs forces us to think in terms of systems and to adopt a ‘systems-approach’. Dr. John Finley, National Program Leader in Human Nutrition USDA/ARS, shed some light on this term and explained how the growing chasm between food, agriculture, health, and nutrition has increased over the years, and is reflected in the way research is presently being done. In short, each discipline carries out its own research with its own agenda. This often results in agriculture on one side, with nutrition and public health on the other.
Nevertheless, how can the gap between the two be bridged? A systems-approach to agriculture, nutrition, and health quantifies inputs, outputs, and models outputs to make predictions. It needs to be realistic by accurately assessing the challenges and dealing with the realities of each discipline and be economically sustainable.
Practically speaking, integration rather than collaboration is required. In the past, these sectors have largely worked in a collaborative, ad-hoc manner whereby one expert would reach out to another to get questions answered. However, what we desperately need today is to develop a more integrative research strategy that includes the various disciplines right from the outset; this strategy will need to identify the single challenge of national and international importance, determine hypotheses, and then adopt a multidisciplinary approach.
The USDA Agricultural research service uses the ‘GEM-to-P Approach’:
- Every challenge has the following components:
- Genetic: knowledge of genotype
- Environmental: effect of production on the environment and vice-versa
- Management: optimizing the output
- Post-harvest: nutrition, optimizing nutrition, reducing food waste etc.
Dr. John Finley (USDA-ARS)
All in all, a part of what has caused the challenges of colliding epidemics, fragmented food systems, and sustainable diets is a failure to work in an integrative fashion across the areas of health, nutrition, agriculture, and the environment. Rectifying this will require urgent cross-sectoral mobilization, likely to occur through generating further commonality and clarification around language, metrics, and data.
Large datasets must speak to each other. For example, a central system where data could migrate to and be analyzed in a way that links can be made between these very disparate groups would be beneficial. Additionally, stakeholder input, notably from the food industry, is critical – what do they have to say and what do they need?
Also, as accurately pointed out by Dr. Howarth Bouis, Founder and Director of HarvestPlus, funding for institutional collaboration is required and success will depend on getting each sector’s buy-in. Finally, a few terms need defining among all parties, e.g.: what is meant by “sustainability” or what is the difference between “food”, “diet” and “nutrition”? Bringing economists, anthropologists, and ethnographers more central to the question is fundamental as demand is hugely determined by culture and traditions.
Dr. Gerald F. Combs, Emeritus Professor of Nutrition at Cornell University, looked at the next steps for achieving the session goals. He suggested assembling and tasking multidisciplinary research teams, in addition, creating multi-institutional consortia with shared portfolio of broad, multi-disciplinary expertise of academic governments and corporate research institutions. A new pedagogy for holistic thinking about agriculture-food-nutrition-health systems in a way that facilitates long-term decision-making needs to be developed. It is hoped that this dialogue will continue well beyond the American Society for Nutrition and in the not-so-distant future.
Emerging Evidence of WASH on Stunting
Many of us have impatiently been waiting for the results of the Water, Sanitation & Hygiene (WASH) benefits trials. The Monday morning session on “Emerging Evidence of Impact of Integrated WASH and Nutritional Intervention on Child Growth, Diarrheal Diseases, and Cognitive Development” provided the long-awaited preliminary results of these studies.
Based on the current evidence of these randomized controlled trials (RCTs), the potential of WASH interventions to contribute to reduction in growth faltering is ambiguous. Indeed, as Dr. Andrew Prentice described during the symposium, these RCTs do not support these interventions as having an impact on growth faltering, though they are in several settings.
Additionally, they do not produce profound change in the environment in the way that a robust intervention would (e.g.: ensuring the community is radically not exposed to the fecal stream, adding drinking water and food and having the immediate environment without contaminated faeces), which may shed some light on these preliminary results. However, are there other factors that may have played a role? For instance, time constraints that are known to place significant demands on the caregivers or community workers? How can these be better captured and could they offer an explanation as to what is going on?
Growing Momentum for Implementation Research?
Many of the sessions at Experimental Biology focused on implementation research, with a wide variety of topics ranging from theory to practice which all provided valuable insights into improving the effectiveness of nutrition programs. One such session detailed a captivating network analysis study conducted by the International Food Policy Research Institute (IFPRI) in India, looked at both identifying the complex set of interconnected stakeholders and understanding how their interactions influence maternal and child health policy and program decisions related to nutrition.
The study also tested the use of a participator network-mapping tool to identify policy actors and the scale and scope of actor networks in a nutrition policy space. The results revealed that civil society organizations, a network of smaller organizations and government ministries, were seen to be among the most influential actors who could be engaged with to mobilize knowledge and evidence about nutrition at both national and state level in India.
Dr. Chaza Akik, Postdoctoral Research Fellow at the American University of Lebanon, shared how implementation research had helped explain the reasons behind iodine deficiency among schoolchildren in Lebanon. Despite a universal salt iodization law in place, major barriers to proper implementation were identified, such as loopholes in the law, outdated infrastructure, and capacity of salt producers.
A presentation by Dr. Parul Christian, Senior Program Officer, Women’s Nutrition at Bill & Melinda Gates Foundation, on the momentum around the need for further implementation research for the nutrition of adolescent girls and young women, further supported the increasing attention implementation research deserves and needs.
Equipping the Younger Generation to Lead
At Sight and Life, we are used to building bridges for nutrition and constantly work to close the gap between high scientific advances in product innovations and low scientific advances in implementation models. As showcased during Managing Director of Sight and Life, Dr. Klaus Kraemer’s presentation on “Translation of nutrition research and program findings: some advice”, partnerships, systems-approaches, implementation science and leadership development are all vital elements to bridging the gap. Of equal importance is the need to engage the younger generation and encourage cross-disciplinary training and collaboration in universities. This will enable empowerment of future leaders and assist them to make the right, evidence-based decisions when facing these types of hybrid and complex challenges.
“Implementation Science and Leadership Development are the New Frontiers in Nutrition”– Dr Klaus Kraemer, Managing Director for Sight and Life
Experimental Biology is a fantastic platform to further these discussions started with some of the brightest minds in the field. Now is the time to walk the talk and bring all stakeholders to the table to act on these opportunities and equip the future generation to lead where they stand, as Dr. Anna Lartey, Director of FAO, rightly puts it!
Find out more about Experimental Biology Conference by visiting their website.